Improving Pediatric Diabetes Care with the T1DX-QI Program Using PDCA
The proposed quality improvement project is to implement the T1D Exchange Quality Improvement (T1DX-QI) Collaborative program within the diabetes care clinic. The project will test the effectiveness of the T1DX-QI collaborative as compared to standard diabetes care in improving glycemic control, adherence to medication, and quality of life for children with type 1 diabetes (T1D). The Plan-Do-Check-Act (PDCA) has been selected as the best change theory/model that will work best for this project. Evidence from nursing research has shown that the PDCA method can significantly help improve the quality of nursing care with notable effects on costs, patient-centeredness of care, patient management, and medical costs (Tamher et al., 2021). This article summarizes the main theoretical notions and concepts of the PDCA and discusses in detail the various stages of implementation of the proposed T1DX-QI collaborative project based on the PDCA.
Plan-Do-Check-Act (PDCA) Theoretical Notions and Concepts
The PDCA is a change model and a quality management framework with four interconnected stages, which include the Plan, Do, Check, and Act, and are applicable to continuous quality improvement (Isniah et al., 2020). From a theoretical perspective, the planning stage recognizes the need for and to plan for change based on an identified opportunity for such change. It also presents the concepts of defining goals, key quality indicators, key stakeholders, and planning for the implementation of the QI project.
The second stage presents the theoretical notion that involves implementing and testing the targeted change on a small scale within the organization and observing how such change impacts the organization’s systems (Isniah et al., 2020). It presents the concepts of targeted intervention implementation, data collection, and monitoring. The third stage, check, introduces the theoretical notions of assessing the quality and efficiency brought about by implementing targeted intervention and comparing the outcomes against the set goals at the planning stage. The check stage introduces concepts such as data analysis, data evaluation, progress review, and outcomes assessment.
The final stage of the PDCA, the act stage involves taking action based on the outcomes of the check stage. It introduces the concept of change implementation if the outcomes of the check stage are desirable enough to implement the change on a large scale. It also introduces the concept of intervention modification and the entire concept of continuous improvement by allowing the entire PDCA cycle to be repeated if the outcomes do not align with the established goals.
Application of the PDCA in the Implementation of the T1DX-QI Collaborative Project
The T1DX-QI Collaborative project will be implemented and tested within the diabetes care clinic using the four phases of the PDCA methodology to determine whether and how the T1D QI project will be successful. The T1DX-QI Collaborative project implementation will be divided into four stages as per the PDCA. The first stage, in accordance with the theoretical notions and concepts of the Plan stage, will include the definition of the need for QI in the diabetes clinic, setting specific, measurable, and achievable goals within the set time of 12 months, and stakeholder identification. The second stage is implementing the T1DX-QI Collaborative project on a pilot basis. The third stage is a review of the data from the implemented T1DX-QI Collaborative project, including collection, analysis, and review of data on glycemic control, medication adherence, and quality of life among the select participants. The final stage of implementing the project as per the PDCA will involve standardizing the outcomes of the pilot project into the main practice settings within the entire diabetes care clinic. The outcomes will also be modified to meet the needs of individual patients and collect feedback from the patients and other stakeholders to help with continuous QI in T1D care. Conclusively, the PDCA change model can guide the implementation of the T1DX-QI Collaborative project, help achieve notable changes in T1D care among children, and support QI in T1D care.
References
Isniah, S., Purba, H. H., & Debora, F. (2020). Plan do check action (PDCA) method: literature review and research issues. Jurnal Sistem Dan Manajemen Industri, 4(1), 72–81. https://doi.org/10.30656/JSMI.V4I1.2186
Tamher, S. D., Rachmawaty, R., & Erika, K. A. (2021). The effectiveness of Plan Do Check Act (PDCA) method implementation in improving nursing care quality: A systematic review. Enfermería Clínica, 31, S627–S631. https://doi.org/10.1016/J.ENFCLI.2021.07.006
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Question 
Improving Pediatric Diabetes Care with the T1DX-QI Program
This week, you will select Lewin’s change theory or the PDCA that would work best for your proposed quality improvement project. In a one- to two-page paper, you will need to summarize the main theoretical notions and concepts of the selected theory. You will then need to discuss in detail the various stages of implementation of the proposed project based on the selected theory.